The invention relates to a device for transanal rectum extraction comprising a rectoscope sleeve with a tubular end portion and a resectate extractor extending through the end section and the sleeve for retracting resectate into the rectoscope sleeve.
Neoplasm (the growth of new tissue such as a tumor) and angiodysplasm (the formation of vessels) in the sigma intestinal area may require resection of this portion of the intestines between the colon descendens and the rectum. With such a resection the intestine is cut in front of and behind the sigma per laparoskopiam by means of optical and surgical instruments inserted through the abdominal wall. Before the colon descendens and the rectum can be interconnected the resectate has to be removed. The resectate is extracted by way of the anus.
For the extraction of the resectate a rectoscope sleeve is usually inserted transanorectally and the proximal end thereof, that is, the end near the operator, is closed by a connecting piece. Rectoscope sleeves with an outer diameter of 40 mm and of various lengths are commercially available. The known rectoscope sleeves are inclined at their distal end, that is, the end remote from the operator. They are inserted with the aid of a so-called mandrin which is a rod with a thickened end portion in the shape of a cone or a rounded cylinder at the distal end whose diameter is slightly less than the inner diameter of the rectoscope sleeve. The connecting piece of the rectoscope sleeve includes a pipe nozzle through which carbon dioxide may be introduced for expanding the intestine. Through an opening in the connecting piece a pair of grasping pincers is advanced through the rectoscope sleeve into the rectum. The laparascope operator passes the resectate onto the grasping pincers by which it is removed transanally through the resectate sleeve.
Such a rectoscope sleeve with a connecting piece is shown in FIG. 1 of DE 33 29 784 C2. Furthermore there is shown a pair of grasping pincers which is inserted through the connecting piece into the rectoscope sleeve.
During transanorectal insertion of the grasping pincers into the abdomen with the described procedure--depending on the anatomy and histology of the intestine portion which is not protected by the rectoscope sleeve and depending on the experience of the surgeon and the design of the grasping pincers--lesions and/or perforations are possible.
DE 38 23 604 A1 discloses an apparatus for the intra-cavity irradiation of malignant colon tumors. The apparatus shown therein includes a tubular structure corresponding to a rectoscope sleeve and an insertion member consisting of a tube with a club-like thickened end. The club-like thickened end is hollow so that radioactive material can be supplied to a point adjacent the area to be treated.
Further, DE 82 33 240 U1 discloses a rectoscope which includes a short, wide, tubular structure with a rotatable connecting ring. A mandrin extends through the tubular structure. After removal of the mandrin, as a connecting piece an instrument carrier is placed onto the tubular structure and is connected thereto by means of a bayonet type fitting. Locking is achieved by the engagement of locking balls in an annular groove.
It is the principal object of the present invention to provide an improved device with which an intestine section can be extracted transanally with relatively little chance for lesions or perforations of tissue and wherein such extractions can be performed requiring only simple and rapid manipulations by the surgeon.